1

Cysts, fibroadenoma:
Cysts and fibroadenomas are two non-cancerous breast masses that can be found in men. Although male breast cancers only account for 1% of all breast cancers, a suspicious mass should always be evaluated. Your lump should be evaluated with a combination of physical exam, mammography and ultrasound as necessary. Please follow up with your PCP.
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2

Engorgement of tissu:
Appears to be the engorgement- enlargement of small areas of breast tissue.As it is closer to the surface near the nipple you are able to feel. If related to the menstrual cycle,indicates the swelling localized island of breast tissue in response to hormonal factors of menstrual cycle. this is nothing to worry. Hot compresses /warm soaks may help to reduce pain, if very painful.
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5

Follow-up as advised:
A palpable abnormality or breast lump should not be ignored. Sounds like you are working with your doctor to figure out what is going on. While many benign processes can cause the problem you are describing, you should be diligent in its workup with your doctor. A hard lump which is immovable can be a finding of breast cancer you should not ignore.
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6

See a Breast Surgeon:
At 40 a moveable lump is likely benign, but there is no way to know without an evaluation. A Breast Surgeon can examine you and perform an Ultrasound, a non-invasive imaging test to determine if it is a cyst or a solid mass. Then together you can decide whether it should be biopsied, removed, or simply observed.
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8

Get checked:
While it is likely a cyst or benign change associated with your monthly cycles, rarely at your age other changes can occur that need attention like infections or benign tumors or rarely cancer. Breast cancer in a 22yo without a strong family history is rare but if this is a painless lump that enlarges or persists then you should be examined.
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